Insurance Billing Lead, Behavioral Health Claims & Denials
Overview
Own the end-to-end insurance billing lifecycle for behavioral health at scale within a mission-driven AI healthcare company. You will work with Revenue Operations to reduce denials and optimize reimbursement processes for a large patient population. This role blends hands-on claims management with system thinking to deliver accurate, timely payments and a frictionless patient experience. What makes this role different is the direct impact on both clinical operations and the economics of care through scaled, compliant processes and cross-functional collaboration.
What You'll Do5
- 1Build and manage end-to-end claims lifecycle from submission to reimbursement, resolving holds and appealing denials
- 2Design and implement processes to resolve behavioral health claim denials for coverage gaps, prior authorizations, documentation, and coding
- 3Investigate denial reasons, perform payer calls or patient outreach to resolve issues and improve collection rates
- 4Own tracking of follow-ups and escalations, driving issue resolution across systems and teams
- 5Partner with Revenue Operations and practice management tools to streamline workflows and reduce denial rates
Requirements5
- 11+ years of insurance claims management experience in behavioral health
- 2Experience making payer calls and investigating claim denials
- 3Familiarity with practice management software like Healthie or Candid Health is a plus
- 4Ability to process 30+ claims per day and maintain accurate tracking of follow-ups
- 5Strong organizational skills and ability to manage denial resolutions end to end
Salary Insight
Salary not disclosed in listing
Location
Required Skills
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